Detection of causative agents of bacterial pneumonia in hospitalized hajj and umrah cases by multiplex real-time polymerase chain reaction

Vivi Setiawaty; Dini Darmawati; Arie  Ardiansyah Nugraha; Pancrasia Maria Hendrati

doi:10.18502/ijm.v14i3.9759

Vivi Setiawaty Research Instalation, National Infectious Diseases Prof. Dr. Sulianti Saroso, Ministry of Health, Jakarta, Indonesia
Dini Darmawati Laboratory Division, Faculty of Biology, University of Soedirman, Purwokerto, Indonesia
Arie Ardiansyah Nugraha Laboratory Division, Center for Research and Development of Biomedical and Basic Health Technology, National Institute of Health Research and Development, Jakarta, Indonesia
Pancrasia Maria Hendrati Laboratory Division, Faculty of Biology, University of Soedirman, Purwokerto, Indonesia

DOI: https://doi.org/10.18502/ijm.v14i3.9759

Keywords: Pneumonia; Multiplex real-time polymerase chain reaction; Bacteria; Hajj and umrah

Abstract

Background and Objectives: Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is commonly detected in pneumonia patients who travel from the Middle East regions. Besides MERS-CoV, many other pathogenic agents cause pneumonia. Detection of such organisms must be done swiftly, especially in case of the negative MERS-CoV samples. The aim of this study was to identify the pathogenic agents that might account for bacterial pneumonia, from Hajj and Umrah pneumonia cases.

Materials and Methods: We conducted a cross-sectional study, 38 pneumonia clinical samples from suffering of Hajj and Umrah in 2017 with negative MERS-CoV were selected. The laboratory testing was done at National Reference Laboratory in Jakarta and performed by multiplex real-time PCR using a FTD respiratory pathogens.

Results: Haemophilus influenzae (26.4%) was the most frequent bacteria detected. Other causative agents of bacterial pneu- monia identified were Moraxella catarrhalis (20.8%), Klebsiella pneumoniae (13.2%), Streptococcus pneumoniae (9.4%), and Staphylococcus aureus (5.7%). From 38 samples showed that 25 (65.79%) samples were positive with bacteria, in- cluding five samples with coinfection. The coinfection were combinations among S. aureus and S. pneumoniae (1/20), S. pneumoniae and K. pneumoniae (1/20), S. pneumoniae and M. catarrhalis (2/20), S. pneumoniae and H. influenzae (2/20), K. pneumoniae and H. influenzae (5/20), and M. catarrhalis and H. influenzae (5/20).

Conclusion: Haemophilus influenzae is the most recurrent bacteria to be identified in samples of pneumonia of hajj and umrah cases.